Rogers David L, Neely Daniel E, Chapman Janice B, Plager David A, Sprunger Derek T, Sondhi Naval, Roberts Gavin J, Ofner Susan
Indiana University School of Medicine, Department of Ophthalmology, Section of Pediatric Ophthalmology and Adult Strabismus, Indianapolis, Indiana, USA.
J AAPOS. 2008 Feb;12(1):77-82. doi: 10.1016/j.jaapos.2007.09.004.
The MTI photoscreener (MTI) and the Welch-Allyn SureSight autorefractor are commonly used for preschool vision screening. We compared both of these methods on 100 consecutive patients in a prospective, randomized, masked, clinical trial conducted at a tertiary care center.
One hundred patients between 1 and 6 years of age were included in the study. All participants underwent a comprehensive eye examination with cycloplegic refraction. Examination failure analysis was done on the SureSight data using the manufacturer's referral criteria, the Vision in Preschoolers study (VIP) 90% specificity criteria, the VIP 94% specificity criteria, and the referral criteria proposed by Rowatt and colleagues.
Data were successfully obtained on 76% of children using the SureSight and 96% with the MTI. The sensitivity and specificity of the SureSight to detect clinically significant amblyogenic factors using the manufacturer's criteria was 96.6 and 38.1%, using the VIP 90% criteria was 79.3 and 64.3%, using the VIP 94% criteria was 67.2 and 69.0%, and using criteria proposed by Rowatt and colleagues was 62.1 and 73.8%. The sensitivity and specificity of the MTI photoscreener was 94.8 and 88.1%, respectively.
Using the manufacturer's referral criteria, the SureSight had a sensitivity equal to the MTI photoscreener; however, the specificity was low and over-referrals were anticipated. As specificity levels were increased, a substantial number of children with amblyogenic risk factors were not appropriately identified within our study population..
MTI 视力筛查仪（MTI）和伟伦 SureSight 自动验光仪常用于学龄前儿童视力筛查。在一家三级医疗中心进行的一项前瞻性、随机、盲法临床试验中，我们对连续 100 例患者使用这两种方法进行了比较。
本研究纳入了 100 例 1 至 6 岁的患者。所有参与者均接受了散瞳验光的全面眼部检查。使用制造商的转诊标准、学龄前儿童视力研究（VIP）90%特异性标准、VIP 94%特异性标准以及 Rowatt 及其同事提出的转诊标准，对 SureSight 数据进行检查失败分析。
使用 SureSight 成功获取了 76%儿童的数据，使用 MTI 成功获取了 96%儿童的数据。使用制造商标准时，SureSight 检测临床上有意义的致弱视因素的敏感性和特异性分别为 96.6%和 38.1%；使用 VIP 90%标准时为 79.3%和 64.3%；使用 VIP 94%标准时为 67.2%和 69.0%；使用 Rowatt 及其同事提出的标准时为 62.1%和 73.8%。MTI 视力筛查仪的敏感性和特异性分别为 94.8%和 88.1%。
使用制造商的转诊标准时，SureSight 的敏感性与 MTI 视力筛查仪相当；然而，其特异性较低，预计会出现过度转诊情况。随着特异性水平的提高，在我们的研究人群中，大量有致弱视危险因素的儿童未得到适当识别。
